crossing96/oncoscreening huggingface dataset:
A prospective study evaluating surgery and chemo radiation in muscle invasive bladder cancer.	AIM: The aim of our study was to compare the two standard treatment approaches in muscle invasive carcinoma of urinary bladder--radical cystectomy and chemo radiation. MATERIALS AND METHODS: Transitional cell carcinoma (TCC) of bladder of stages, T2 to T4, N0/N1/N2 and M0 were included in the study. Patients were allotted to two arms of the study. Arm A consisted of radical cystectomy. Adjuvant CMV chemotherapy was given for T3/T4 or Node positive disease only. Arm B received 2 cycles of neoadjuvant CMV chemo therapy followed by concurrent chemo radiation. RESULTS: Forty-four patients were recruited into the study. Thirty patients in the surgical arm and 13 patients in the chemo radiation arm. The actuarial two-year survival rate in surgical arm is 56% while in chemo radiation arm it is 54%. There was no statistically significant difference in disease-free survival also between the two groups. CONCLUSION: Chemo radiation yielded equivalent survival results with radical cystectomy. So it is worth giving preference to chemo radiation that will give a better quality of life for the patient.	bladder
Bladder cancer after radiotherapy for prostate cancer: detailed analysis of pathological features and outcome after radical cystectomy.	PURPOSE: We reviewed outcomes and features in patients with bladder cancer who underwent cystectomy and had a history of radiation for prostate cancer. MATERIALS AND METHODS: We performed a retrospective analysis of the University of Miami cystectomy database and identified 34 patients with a history of radiotherapy for prostate cancer. An age and stage matched control group was used to compare survival. Our entire male cystectomy population was used to compare clinicopathological features. RESULTS: Mean age in the 34 patients with cystectomy was 75 years with a mean latency of 5 years from prostate cancer radiation. Radiotherapy was the primary treatment modality for prostate cancer in 32 of 34 patients and 2 received adjuvant radiation. Of the patients 86% received external beam radiation. Hematuria was the initial symptom in 86% of the cases. In 53% of the patients the initial diagnosis was muscle invasive bladder cancer. An ileal conduit was the method of urinary diversion in 33 cases. Major perioperative complications developed in 9% of the patients. There was 1 perioperative death, resulting in a mortality rate of 2.9%. Of the patients 54% presented with a locally advanced (pT3-4) tumor. Patients with a history of radiation therapy for prostate cancer had significantly poorer overall and bladder cancer specific survival than the matched control group. CONCLUSIONS: Most bladder cancers in patients with a history of radiation for prostate cancer present as locally advanced tumors and patients have poorer survival than age and stage matched controls.	bladder
History of bacillus Calmette-Guerin and bladder cancer: an immunotherapy success story.	PURPOSE: We review how the bacillus Calmette-Guerin vaccine evolved to become standard therapy for superficial bladder cancer. MATERIALS AND METHODS: We reviewed the historical literature describing the origin of the bacillus Calmette-Guerin vaccine as an anticancer agent and its singular success as the most effective immunotherapy used against a human neoplasm. RESULTS: The association between tuberculosis and cancer, and the demonstration that bacillus Calmette-Guerin invoked immunological reactivity, inhibiting tumor growth in experimental animal models, led to clinical trials showing that intravesical bacillus Calmette-Guerin eradicated and prevented recurrence of superficial bladder tumors. CONCLUSIONS: For the last 3 decades bacillus Calmette-Guerin therapy has remained the most effective local therapy for superficial bladder cancer, an outstanding example of successful translational medicine in urology.	bladder
Prognostic impact of comorbidity in patients with bladder cancer.	OBJECTIVE: To determine the impact of comorbidity on survival of bladder cancer patients. METHODS: The population included 675 patients with newly diagnosed bladder cancer whose medical information was abstracted from a hospital cancer registry. Adult Comorbidity Evaluation-27, a validated instrument, was used to prospectively categorize comorbidity. Independent variables assessed include comorbidity, American Joint Committee on Cancer (AJCC) stage, grade, age, gender, and race. Outcome measure was overall survival. We analyzed the entire cohort, patients with noninvasive disease, and patients requiring cystectomy. Cox proportional hazards analysis was used to assess impact of independent variables on survival. RESULTS: Median age at diagnosis for the entire cohort was 71 yr and median follow-up was 45 mo. Of 675 patients, 446 had at least one comorbid condition and 301 died during follow-up. On multivariable analysis for the entire cohort, comorbidity (p=0.0001), AJCC stage (p=0.0001), age (p=0.0001), and race (p=0.0045) significantly predicted overall survival. On subset analysis of noninvasive bladder cancer patients, comorbidity (p=0.0001) and age (p=0.0001) independently predicted overall survival, whereas stage, grade, race, and gender did not. On subset analysis of cystectomy patients, comorbidity (p=0.0053), stage (p=0.0001), and race (p=0.0449) significantly predicted overall survival. CONCLUSIONS: Comorbidity is an independent predictor of overall survival in the entire cohort of bladder cancer patients, the subset with noninvasive disease, and the subset treated with cystectomy.	bladder
Urological implications of concurrent bladder and lung cancer.	BACKGROUND: Multiple primary malignancies are increasingly being detected among cancer patients. OBJECTIVES: To investigate the co-occurrence of primary bladder cancer and primary lung cancer, two established smoking-related neoplasms characteristically associated with increased risk of secondary cancers. METHODS: A retrospective search of the patient registry in our institution identified 25 patients (23 men and 2 women) who were diagnosed with both bladder cancer and lung cancer during the period 1990-2005. Medical records were reviewed and clinical and pathological data were extracted. RESULTS: In 21 patients (84%) bladder cancer was the first primary tumor and in 4 (16%) the second primary tumor. More than 90% of the patients had a history of smoking. Mean smoking exposure was 62.1 pack years (range 30-120). All bladder cancers were transitional cell carcinomas with the majority being superficial at presentation. Most lung cancers were of the non-small cell type. Second primary lung cancers were significantly more advanced at diagnosis. Overall, mean follow-up was 105.8 months (range 6-288). Seven patients (28%) were alive at the time of evaluation; 68% died of lung cancer, while none died of bladder cancer. CONCLUSIONS: Second primary lung cancer may occur in patients with bladder carcinoma and vice versa. In view of the relatively frequent involvement of the genitourinary tract as a site of multiple primary tumors, urologists may have a key role in the detection of second primary tumors arising in the genitourinary tract, or second primary tumors that occur in patients with primary genitourinary tract malignancies.	bladder
Pathological variants of invasive bladder cancer according to their suggested clinical significance.	Several pathological variants of bladder cancer, reflecting tumour heterogeneity in urothelial carcinoma, have been recently recognized. In this review we summarize the most common pathological variants of urothelial carcinoma, with an emphasis on clinical implications. It is important for both pathologists and urologists to be aware of the diverse morphological patterns in invasive bladder cancer, as they might be relevant in patient management and prognosis, mainly because they can mimic benign lesions, secondary tumours or might require a specific therapeutic approach.	bladder
An alternatively spliced KAI1 mRNA is expressed at low levels in human bladder cancers and bladder cancer cell lines and is not associated with invasive behaviour.	Levels of the KAI1 metastasis suppressor are reduced in advanced stages of many human cancers, leading to the loss of KAI1 function. A recent study has suggested that the loss of KAI1 function may also occur via alternative splicing of KAI1 mRNA which deletes an exon encoding a critical 28 amino acids from the protein. Using PCR, 20 bladder tumours at differing stage and grade, a non-tumourigenic urothelial cell line (SV-HUC-1) and 17 bladder cancer cell lines were examined for expression of this alternatively spliced (AS) KAI1 mRNA. Full-length KAI1 mRNA was present in all tumour samples and low levels of AS KAI1 mRNA in 15/20 samples. There was no association between the presence or absence of AS mRNA and clinicopathological characteristics of these tumours. Low levels of AS KAI1 mRNA were present in SV-HUC-1 and 14/17 bladder cancer cell lines. There was no association between the presence or absence of AS KAI1 mRNA and tumourigenicity, or in vivo invasive abilities of these cell lines. In all cell lines expressing AS KAI1 mRNA, levels were 3- to 5-fold lower than levels of wild-type mRNA, irrespective of wild-type mRNA levels. Low levels of an alternatively spliced form of KAI1 mRNA are present in most bladder cancer tumours and tumour cell lines, but are not associated with invasive behaviour.	bladder
Prognostic relevance of disseminated tumour cells in bone marrow of patients with transitional cell carcinoma.	OBJECTIVE: This prospective study is the first immunocytochemical investigation of the frequency and prognostic value of CK+ tumour cells in the bone marrow of patients with transitional cell carcinoma (TCC). METHODS: Bone marrow aspirates from 228 TCC patients were taken preoperatively. Cytospins were made and stained by immunocytochemistry using the monoclonal antibodies CK2 and A45-B/B3. 27 patients with no evidence of any malignant disease served as control group. RESULTS: CK+ tumour cells were detected in 28% (63/228) of the TCC patients. No CK+ cells (0/27) were detected in the control group. In multivariate analysis the detection of > or =3 CK+ cells in bone marrow was an independent prognostic factor (hazard ratio=2.7, p<0.05) in patients with T2-4 tumour classification. CONCLUSION: Disseminated CK+ cells play a role in the biology of tumour spread of TCC, and their immunocytochemical detection can be useful in assessing the prognosis of TCC patients with an invasive tumour.	bladder
[Superficial urinary bladder tumors treatment results--a 10-year experience].	BACKGROUND/AIM: The most common urinary bladder tumors are superficial tumors. Due to their tension to relapse and progress towards deeper layers after surgical therapy, an adequate therapy significantly contributed to the improvement of the results of urinary bladder tumors treatment. Staging and gradus of the tumor, presence of the cardnoma in situ (CIS) or relapses significantly influenced the choice of the therapy. The aim of this study was to ascertain the effectiveness of the intravesicelly applied BCG (Bacille Colmette-Guerin) vaccine or chemiotherapy in the prevention of the relapses and further progression of superficial urinary bladder tumors. METHODS: All of the diagnosed superficial tumors of bladder were removed by transurethral resection (TUR). After receiving the patohistological finding they were subjected to adjuvant therapy, immune BCG vaccine or chemiotherapy (epirubicin, doxorubicin, mitomycin-C). The third group did not accept adjuvant therapy, but had regularly scheduled cystoscopic controls. The appearance of relapses, progression of stage and gradus of the tumor, as well as possible unwanted effects of adjuvant therapy were registered. RESULTS: The applied immunotherapy (BCG) influenced decreased tumor relapses (7%) and statistically important difference between patients who had taken adjuvant chemotherapy (relapses 18.4%) and those without this therapy was acknowledged. Gradus of tumor did not show statistically significant difference on tumor relapse. A significantly longer period of time in the appearance of tumor relapse after BCG (29.33 months), had significant importance comparing to chemio (9.44 months) or non-taken adjuvant therapy (9.84 months). Very small number of unwanted effects suggested an obligatory undertaking adjuvant therapy after TUR of superficial tumors. CONCLUSION: A significant decrease of relapses as well as avoidance of further progression of urinary bladder tumors, has introduced adjuvant therapy in all of the protocols, while the dosing scheme is not unique yet due to trying to find the optimal dose, the length of application and possible dose maintenance.	bladder
[Pubic tubercle side approach to the obturator nerve block].	BACKGROUND: The authors describe the pubic tubercle side approach of the obturator nerve block for the management of adductor muscle constriction associated with the transurethral resection of the lateral wall bladder tumor. METHODS: The pubic tubercle side approach of the obturator nerve block was performed by a inserting needle at the midpoint of the femoral artery and the pubic tubercle. After the needle encountered the superior ramus of pubis, the needle was redirected vertical or slightly caudal, passeing the vicinity of the inferior margin of the superior ramus of pubis, and then advanced to the trunk of the obturator nerve. The obturator nerve was identified by its response to nerve stimulation. The pubic tubercle side approach using more than 5 ml of 1.0% lidocaine was performed by a single injection until there was no response to nerve stimulation. On the other hand, by the traditional approach to the obturator nerve block, after the initial local anesthetic injection the needle was redirected lateral and slightly caudal. If the response to nerve stimulation was still elicited, more local anesthetic was administered. RESULTS: Evaluation of the efficacy of the pubic tubercle side approach was performed in-terms of quantity of the local anesthetic used and the success rate. In comparison with the traditional approach, a smaller dose of local anesthetic was used in spite of the higher success rate. CONCLUSIONS: The pubic tubercle side approach of the obturator nerve was useful and without complications in comparison with the traditional approach.	bladder
Survivin: a promising biomarker for detection and prognosis of bladder cancer.	Survivin is a 16.5 kDa member of the inhibitor of apoptosis protein family that is overexpressed in many malignancies but rarely detected in normal differentiated adult tissues. Functionally, Survivin inhibits apoptosis, promotes cell proliferation, and induces/enhances angiogenesis. In transitional cell carcinoma of the urinary bladder, Survivin has been shown to be a promising biomarker for cancer diagnosis, prognosis and prediction of response to intravesical or systemic therapies. Moreover, in pre-clinical bladder tumor models, inhibition of Survivin expression and/or function has been shown to impede tumor cell proliferation, and markedly induce spontaneous or chemotherapy induced apoptosis. These preliminary findings should now be confirmed in large prospective trials. Furthermore, simplified, quantitative and reproducible assays need to be developed and validated for the detection of Survivin and its different isoforms.	bladder
Gemcitabine and paclitaxel chemotherapy as a second-line treatment for advanced or metastatic urothelial carcinoma.	OBJECTIVES: We report that a combination of gemcitabine and paclitaxel will effectively treat patients with advanced urothelial carcinoma (UC) who have been previously treated with methotrexate, vinblastine, adriamycin, and cisplatin (MVAC). The objective of this study was to assess the tumor responses, toxicity, and overall survival of these patients as second-line treatment. METHODS: Ten eligible patients were enrolled in this study. All patients had been previously treated with MVAC. Patients received paclitaxel 200 mg/m(2) on day 1 and gemcitabine 1000 mg/m(2) on days 1, 8, and 15. The treatment was repeated every 21 days. Tumors were assessed every two cycles by imaging study. RESULTS: The median number of treatment courses was 4 (range 2-7). Two patients had complete response and five patients had partial response after two courses of treatment. Median overall survival was 10.3 months. Median overall survival from the first MVAC was 19.1 months. Median progression-free survival was 4.1 months. Of the seven responders, median progression-free survival was 7.4 months. Myelosuppression was the most common toxicity. Nonhematologic toxicity consisted of hypersensitivity reactions to paclitaxel. There were no therapy-related deaths. CONCLUSIONS: Gemcitabine and paclitaxel chemotherapy is a favorable therapeutic alternative for patients with advanced or metastatic UC who have previously been treated with MVAC chemotherapy. Given the safety and benefit profile seen in this study, a large prospective research study is warranted to consider the potential role of gemcitabine and paclitaxel chemotherapy as a second-line treatment for urothelial cancer.	bladder
Hematuria: portal venous phase multi detector row CT of the bladder--a prospective study.	PURPOSE: To prospectively determine the accuracy of portal venous phase helical multi-detector row computed tomography (CT) for bladder lesion evaluation in patients with hematuria by using cystoscopy as the reference standard. MATERIALS AND METHODS: The study was approved by the institutional review board for human investigation, and informed consent was obtained from all patients. This study included 118 patients (91 male, 27 female; age range, 15-87 years; mean age +/- standard deviation, 62 years +/- 14) who underwent portal venous phase multi-detector row CT (scanning delay, 70 seconds; section thickness, 2 mm) and conventional cystoscopy because of painless gross hematuria or recurrent microscopic hematuria. Two reviewers with different experience levels independently evaluated the bladder for lesions at CT in a prospective fashion. The kappa statistic was used to determine the per lesion and per patient agreement between the two reviewers and between the CT and cystoscopic findings. The sensitivity and specificity of multi-detector row CT for bladder lesion detection were analyzed for numbers of lesions and for numbers of patients. RESULTS: Multi-detector row CT showed excellent per lesion (kappa = 0.839) and per patient (kappa = 0.881) agreement between the two reviewers. Respective per lesion and per patient agreement between the CT and cystoscopic findings was also excellent in the first (kappa = 0.866 and kappa = 0.881) and second (kappa = 0.802 and kappa = 0.863) reviewers. The sensitivity and specificity of multi-detector row CT were 89%-92% and 88%-97%, respectively, in the per lesion analysis and 95% and 91%-93%, respectively, in the per patient analysis for both reviewers. All statistical parameters of diagnostic accuracy were similar between the two reviewers (P > .05). CONCLUSION: Portal venous phase multi-detector row CT can provide high accuracy and reader agreement for bladder lesion detection in patients with painless gross hematuria and recurrent microscopic hematuria; these results indicate that multi-detector row CT can be used as the initial bladder examination in such patients.	bladder
Erysipeloid cutaneous metastasis from bladder carcinoma.	Cutaneous metastases from bladder cancer are uncommon, especially in the female population. Although their clinical presentation may vary, the erysipelas-like appearance and the lower extremities location represent exceptional features. We describe a 56-year-old female with a history of bladder adenocarcinoma (T3N0M0) who presented erythematous plaques with an erysipelas-like appearance located on the groins and thighs. Histopathology and immunohistochemistry from skin lesions were consistent with metastases from bladder carcinoma. We report this case for the unusual clinical features and because an early recognition of cutaneous metastases from genitourinary malignancies is important in clinical practice.	bladder
Lymphovascular invasion is independently associated with poor prognosis in patients with localized upper urinary tract urothelial carcinoma treated surgically.	PURPOSE: We explored the prognostic impact of lymphovascular invasion in patients with localized upper urinary tract urothelial carcinoma. MATERIALS AND METHODS: The clinical records of 135 patients treated surgically for localized upper urinary tract urothelial carcinoma (pTa-3N0M0) were reviewed retrospectively. Lymphovascular invasion was defined as cancer cells in an endothelium lined space. Actuarial survival curves were calculated by the Kaplan-Meier method. Differences between survival curves were evaluated by the log rank test. Multivariate analysis was performed using the Cox proportional hazard model. RESULTS: Median followup was 55 months (range 3 to 232). Lymphovascular invasion was present in 57 patients (42.2%) and it was associated with higher pathological T stage and higher tumor grade. Recurrence-free and disease specific survival rates in patients with lymphovascular invasion were significantly worse than those in patients without lymphovascular invasion (p = 0.001 and 0.001, respectively). Multivariate analysis revealed that lymphovascular invasion, patient age and pathological T stage were significant prognostic factors for recurrence-free and disease specific survival. Based on multivariate analysis patients were divided into 4 risk groups, including pT2 or less/negative lymphovascular invasion, pT2 or less/positive lymphovascular invasion, pT3/negative lymphovascular invasion and pT3/positive lymphovascular invasion. Recurrence-free and disease specific survival rates in patients with pT3/positive lymphovascular invasion were significantly worse than rates in the other 3 groups (each p <0.001). CONCLUSIONS: The current study indicates that positive lymphovascular invasion predicts poor survival in patients with pathologically localized upper urinary tract urothelial carcinoma. Risk stratification based on lymphovascular invasion status and pathological T stage would be helpful for selecting patients at high risk who would be appropriate candidates for clinical trials.	bladder
Holmium laser treatment for low grade, low stage, noninvasive bladder cancer with local anesthesia and early instillation of mitomycin C.	PURPOSE: We evaluated the results of laser photocoagulation of recurrent low stage noninvasive bladder cancer. MATERIALS AND METHODS: The study included 36 patients with a recurrent superficial papillary tumor within 1 year of endoscopic resection. Patients underwent laser photocoagulation of the recurrence under local anesthesia and sedation. They received early instillation of 40 mg mitomycin C and were discharged home without a catheter a few hours after the operation. Patients completed a visual analog scale to quantify the perceived level of pain, including 1--no pain to 10--maximum pain. Patients were reviewed after 3, 6 and 12 months to evaluate tumor recurrence. RESULTS: The mean and median visual analog scale score was 3 points (range 1 to 10). No patient had urinary infection or a catheter at hospital discharge. The incidence of recurrence at 12 months was 25%, mainly in the first 15 cases. CONCLUSIONS: Laser photocoagulation with local anesthesia and sedation is easy to perform and well tolerated. There were no complications and the recurrence rate was similar to that of transurethral resection, as calculated using the recurrence calculator of the 2006 guidelines on TaT1 (nonmuscle invasive) bladder cancer from the European Association of Urology.	bladder